Pertussis (cont.)

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

What are whooping cough symptoms, signs, and stages?

The incubation period, or the time frame in which symptoms develop, is longer than that for the common cold and most upper respiratory infections. Typically, signs and symptoms develop within seven to 10 days of exposure to pertussis, but they may not appear for up to three weeks after the initial infection. The first stage of whooping cough is known as the catarrhal stage. In the catarrhal stage, which typically lasts from one to two weeks, an infected person has symptoms characteristic of an upper respiratory infection, including

It is important to note that particularly during this early phase of infection, individuals may believe they have a common cold and may not be aware that they are infected with the pertussis bacterium.

The cough gradually becomes more severe, and after one to two weeks, the second stage begins. It is during the second stage (the paroxysmal stage) that the diagnosis of whooping cough usually is suspected. The following characteristics describe the second stage:

There are bursts (paroxysms) of coughing, or numerous rapid coughs, apparently due to difficulty expelling thick mucus from the airways in the lungs. Bursts of coughing increase in frequency during the first one to two weeks, remain constant for two to three weeks, and then gradually begin to decrease in frequency.

At the end of the bursts of rapid coughs, a long inspiratory effort (breathing in) is usually accompanied by a characteristic high-pitched whoop sound for which the disease is named.

During an attack, the individual may become cyanotic (skin and mucous membranes may turn blue) from lack of oxygen.

Children and young infants appear especially ill and distressed.

Vomiting (referred to by doctors as post-tussive vomiting) and exhaustion commonly follow the episodes of coughing.

The person usually appears normal between episodes.

Paroxysmal attacks occur more frequently at night, with an average of 15-24 attacks per 24 hours.

The paroxysmal stage usually lasts from one to six weeks but may persist for up to 10 weeks.

Infants under 6 months of age may not have the strength to have a whoop, but they do have paroxysms of coughing.

The third stage of whooping cough is the recovery or convalescent stage. In the convalescent stage, recovery is gradual. The cough becomes less paroxysmal and usually disappears over two to three weeks; however, paroxysms often recur with subsequent respiratory infections for many months.